Individual provider Active NPI

Abdul M Orra, DO

  • Family Medicine Physician
  • Lakewood, OH
National Provider Identifier
1053474320
Registry record updated Jan 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34003811 Issued in OH
Practice address
13535 Detroit Ave #4
Lakewood, OH 44107
Phone
(216) 226-2626
Fax
(216) 226-6745
NPI assigned
Dec 18, 2006
Last updated
Jan 11, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34003811 OH Primary

Addresses

Primary practice location

13535 Detroit Ave #4
Lakewood, OH 44107

Mailing address

PO Box 357
N Olmsted, OH 44070-0357
Phone (216) 226-2626

Other identifiers 1

IdentifierTypeStateIssuer
0582570MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100913000221 OH Practitioner - Family Practice 8921123167 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia School of Osteopathic Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

13535 Detroit Ave
Suite 4
Lakewood, OH 44107-4625
Phone (216) 226-2626

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
3811OHMDChiropractor
34003811OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Abco Medical Center, L.L.C. Family Medicine CurrentSince Mar 26, 2012 Accepting new patients

Locations

13535 Detroit Ave
Ste 4
Lakewood, OH 44107
Phone (216) 226-2626

Interoperability endpoints

  • Direct secure messaging: aorra38095@ehrdirect.uhhospitals.org
  • Direct secure messaging: drabdulorra@abcomedicalcenter.medentdirect.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326240000000",
    "number": "1053474320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 357",
            "city": "N OLMSTED",
            "state": "OH",
            "postal_code": "440700357",
            "telephone_number": "216-226-2626",
            "fax_number": "216-226-6745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13535 DETROIT AVE #4",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "44107",
            "telephone_number": "216-226-2626",
            "fax_number": "216-226-6745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORRA",
        "first_name": "ABDUL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2012-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34003811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0582570",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, OH

Sources for this page

Verify at the official NPI Registry.